• December 9, 2022
• By admin

Current Issues in Health Care and What Administrators Can Do

Over the last two decades, the health-care industry has undergone dramatic change. Several issues affecting access to care, quality of care, and cost of care have been addressed by industry and political leaders. The COVID-19 pandemic highlighted these issues, as hospitals struggled to treat an influx of patients and public health officials worked to prevent disease spread.

As the pandemic demonstrated, health-care issues are difficult and complex. Students and professionals who are drawn to health care administration because they want to solve such problems should consider graduate school. A Master of Health Administration program, for example, can provide deeper insights into current health-care issues and the solutions that administrators are developing to address these issues.

1. The Expensive Cost of Health Care:

The issue:

The high cost of care is perhaps the most pressing issue in health care right now. According to a Kaiser Family Foundation survey, more than 45% of American adults find it difficult to afford health care, and more than 40% have medical debt. Because of the high cost of health care, many people avoid seeing a doctor when they are sick or avoid preventive health visits entirely. One-quarter of all Americans cannot afford necessary prescriptions and may skip doses or otherwise fail to take medication as directed. Each of these behaviours can lead to serious health problems, raising the overall cost of care.

The answer:

The health care industry, insurers, and state and federal government agencies all have a role to play in lowering health-care costs. Current initiatives centre on a pledge to reduce insurance premiums and implement comprehensive price caps for services.

However, there are administrative steps that health care administrators can take. According to McKinsey research, administrative activities such as billing, scheduling, and insurance filing account for 25% of health care spending. Many of these costs can be cut by automating repetitive tasks, establishing payer-provider communication platforms, and implementing industry-wide changes like improving Medicare quality-of-care reporting.

2. Concerns about Health Equity

The issue:

The health-care industry has long been aware of vast disparities in health-care outcomes among different populations. These disparities are not solely due to income and healthcare costs. Environmental factors, on the other hand, have a significant impact on health and wellness.

These factors include an individual’s ZIP code, race and ethnicity, air and water quality, and access to jobs, housing, education, transportation, and nutritious food.

Furthermore, long-standing racial and social inequities in some communities have resulted in generations of poor health. All of these factors have an impact on an individual’s overall health and access to medical care. When underserved people have a health crisis, it is usually more expensive to treat them, which often leads to death.

The answer:

Health equity solutions, like the high cost of health care, entail the collaboration of local, state, and federal agencies with health care providers. Housing, transportation, and collaboration with health care non-profits and churches can all be used to address environmental issues and improve access to health care for underserved communities.

To meet the needs of patients, health care administrators can implement a variety of programs. Telehealth, for example, can assist patients who do not have access to transportation, as is common in many rural areas — though internet infrastructure remains a challenge. Other programmes include in-home elder care, care teams that help patients get better care, and community partnerships.

3. Technology’s Promise (and Pitfalls)

The issue:

While the current health-care situation offers many opportunities, it can also lead to a slew of issues if not handled correctly. Data has become increasingly important in health care. The difficulty is in managing this vast ocean of data. Even before the pandemic, providers and health care systems generated about 80MB of data per patient per year, according to a Frontiers in ICT report. This data includes not only information from electronic health records (EHRs), but also administrative data such as addresses, demographic information, insurance policy and claim data, payment records, and appointment scheduling.

The solution:

Artificial intelligence (AI) is having an increasing impact on health care delivery and administration. AI and machine learning can improve the efficiency of simple, repetitive tasks like patient intake and scheduling. This allows employees to focus on more complex issues, saving time and money. AI can also help predict staffing needs, allowing administrators to staff more effectively. Furthermore, doctors can use AI to complete administrative tasks, freeing up their time to focus on patient care. Finally, some administrators and health insurers have begun to use big data analytics and artificial intelligence (AI) to predict health risks and track and analyse disease outbreaks such as COVID-19.

4. The Transition to Value-Based Care

The issue:

In the United States, health care providers have traditionally used a fee-for-service (FFS) model. FFS means that medical staff bills for each service provided using pre-determined billing codes. The more care a doctor provides, the more money he or she is paid, which some critics say leads to unnecessary tests and treatments.

The transition to a value-based care (VBC) system is well underway. Medicare and insurers pay providers based on outcomes in value-based care. Hospitals, for example, are incentivized to reduce readmission rates, which means they focus more on reducing medical and surgical errors. Health-care leaders anticipate that VBC will improve population wellness while decreasing hospital admissions and illnesses. However, proper treatment billing is no longer possible.

The solution:

Health care administrators are transitioning to value-based administration (VBA) and payment and billing tools that can handle this new approach to care. This technology must track treatments, health programmes, and outcomes — and bill accordingly — by utilising patient data and health care data analytics. Dashboards for health administration must be able to track population and individual health outcomes. These dashboards must be able to quantify health care outcome data and take into account social determinants of health and other factors. Hospitals and other providers, Medicare and private insurance companies, and public health programmes are all stakeholders in VBA.

5. The Increasing Provider Scarcity

The issue:

The pandemic brought to light one of the most serious issues in health care: a shortage of providers. Several factors contribute to this shortage, including an ageing population that requires more medical care; localised health care provider shortages, in which a region lacks sufficient numbers of doctors and nurses to serve the community; and burnout, which occurs when medical staff are overwhelmed and overstressed, or work too many shifts, leading some to leave the profession.

According to the Association of American Medical Colleges, the country will face a physician shortage of nearly 140,000 by 2033 due to increased demand.

According to the US Bureau of Labor Statistics, demand for registered nurses will increase by 9% between 2020 and 2030. Advanced practise nurses, such as nurse practitioners and nurse anaesthetists, are expected to grow at a rate of 45%.

According to the Health Resources and Services Administration, approximately 96 million Americans live in a designated Health Professional Shortage Area (HPSA). These areas are frequently, but not always, rural. They may be lacking in primary care physicians or nurse practitioners, as well as dentists and mental health providers.

The solution: To address the shortage, providers are coming up with novel solutions. This could imply revamping recruitment efforts and focusing on long-term workforce planning. To create an appealing compensation package, health administrators may need to examine salary, paid time off, and benefits. Taking steps to ensure departments have an adequate staffing level can help prevent overwork, medical errors, and burnout. Other changes could concentrate on training and advancement opportunities in order to boost employee satisfaction.